Circulating interleukin-1 and tumor necrosis factor in septic shock and experimental endotoxin fever.
Interleukins (IL) -1 beta and -1 alpha and tumor necrosis factor (TNF-alpha) were measured by radioimmunoassay in plasma samples from 44 healthy individuals, 15 patients in septic shock, and 6 volunteers infused with endotoxin. Plasma IL-1 alpha levels were low (40 pg/ml) or undetectable in all situations. In 67% of the healthy subjects, plasma IL-1 beta levels were less than 70 pg/ml. Septic patients had higher plasma IL-1 beta levels (120 +/- 17 pg/ml, P = .001); those of surviving patients were higher than those of patients who died (P = .05). Plasma TNF-alpha concentrations in septic individuals were elevated (119 +/- 30 pg/ml) and correlated with severity of illness (r = .73, P = .003), but no correlation was observed between plasma IL-1 beta and TNF-alpha concentrations in individual samples. Infusion of endotoxin caused a twofold elevation of IL-1 beta, from a baseline of 35 +/- 5 pg/ml to a maximum of 69 +/- 27 pg/ml at 180 min (P less than .05). Peak TNF-alpha levels after endotoxin infusion were 15 times higher than IL-1 beta levels, were attained more rapidly (90 min), and as with the septic patients, did not correlate with IL-1 beta levels. These data support the concept that plasma IL-1 beta and TNF-alpha concentrations are regulated independently and are associated with different clinical outcomes.
Cannon
J G
JG
Department of Medicine, New England Medical Center, Boston, MA 02111.
Tompkins
R G
RG
Gelfand
J A
JA
Michie
H R
HR
Stanford
G G
GG
van der Meer
J W
JW
Endres
S
S
Lonnemann
G
G
Corsetti
J
J
Chernow
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004731:Endotoxins / Q000008:administration & dosage*; D005260:Female; D005334:Fever / Q000097:blood* / Q000139:chemically induced; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D004731:Endotoxins; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; C044101:endotoxin, Escherichia coli